NHS England announces £55 million cash boost to end hospital referrals by second class post

NHS England has set aside £55 million to reward GPs and hospitals to switching to making referrals digitally by 2018, calling time on the practice of referring patients to hospital by second class post.

At the moment around 50% of patients are referred for hospital appointments electronically.  It is intended this will increase rapidly to 60% by September 2016, 80% by 2017 and 100% by 2018.

NHS England and NHS Improvement also plan to consult on a proposal that by 2018 NHS commissioners and providers will no longer be paid for referrals made by paper.

Director of Digital Technology Beverley Bryant says: “For a long time our first class healthcare system has been let down by outmoded systems, where patients are referred to hospital by second class post. We have a duty of care that extends beyond providing effective treatments. We must also provide an effective patient experience that ensures patients feel reassured at a time when they are most vulnerable.”

Actions announced today are:

  • To encourage clinical commissioning groups (CCGs) to support GPs and hospitals to adopt the practice of electronic referrals, NHS England will release up to £55m of funding through the 2016-7 Quality Premium, a scheme designed to reward CCGs for improvements in quality of services.
  • There will be further payments for hospitals to adopt the practice of processing electronic referrals next year through a 2017-18 Commissioning for Quality and Innovation (CQUIN), which recognises excellence and improvement in providers.
  • In 2018, NHS England and NHS Improvement will consult on whether the requirement to complete and process referrals electronically becomes a condition of the national tariff meaning that commissioners and providers would no longer be paid for referrals made by paper.

Completing referrals electronically allows GPs to book in patients’ hospital appointments right away and offer them a choice of date.  Under these plans, patients will leave their GP practice with a scheduled appointment in the diary, ending the days of anxious waits for the post to arrive and frustrating calls to chase hospital letters.

Emerging research undertaken by the National Audit Office (NAO) reveals patients are 50% less likely to miss their hospital appointment if they have chosen the date themselves.  Reducing missed appointments frees up clinical time to be spent with other patients and leads to significant financial savings for hospital trusts.  The NAO suggests the NHS could save £51 million a year if every referral was made online.

The initiative is part of an NHS wide drive to increase efficiency which includes making the best use of technology.


  1. kevin riley says:

    All these initiatives are concealing the reality that the NHS is now no longer “national” since the removal of the NHS from democratic control as a result of the fundamental changes introduced by the last Conservative led Government in 2013.
    Even NHS England cannot guarantee that any identified “improvements” are actually implemented by the now “independent” NHS Foundation trusts and Clinical Commissioning Groups – neither can Jeremy Hunt or the Department of Health.

  2. Leah-Anne Woodhouse says:

    In relation to the above article please could you tell me who is leading on this in the Cambridgeshire area and who do we need to contact for an application form to apply for the funding?

  3. Andrew McGregor says:

    Please remember that primary care includes more than just GPs!
    As someone working in a high street opticians practice it is a constant source of frustration that there isn’t routine electronic communication to doctors and hospitals for us. We even have to pay for the stamps on referral letters out of our minimal sight test fee of £21.31 which won’t be increased at all in April 2016
    Get optometrists using e-Referral and email.
    The reliance on “secure” fax is ridiculous in 2016.